Retrospective Case Analysis of Transnasal Endoscopic Resection of Orbital Apex Tumor.

Abstract

Endoscopic endonasal surgery has gained increasing recognition as an effective approach for the management of orbital tumors. In this study, we retrospectively analyzed the clinical data of eight patients with orbital apex tumors (OATs) who underwent endoscopic endonasal resection at the Orbital Disease and Ophthalmic Oncology Department of Shenzhen Eye Hospital between April 2021 and September 2024. The cohort consisted of one male and seven female patients, with a mean age of 41.7 ± 14.2 years. All patients successfully underwent complete tumor resection by the endoscopic endonasal approach, followed by standardized postoperative treatment including anti-inflammatory therapy, corticosteroids, and neurotrophic medications. Histopathological examination revealed five cases of cavernous hemangioma (62.5%), two cases of schwannoma (25%), and one case of metastatic carcinoma (12.5%). During the follow-up period of at least 6 months, visual acuity improved in five patients (62.5%), decreased in two patients (25%), and remained unchanged in one patient (12.5%). No postoperative complications were observed, including ocular motility disorders, visual field defects, cerebrospinal fluid leakage, or hemorrhage. All patients with benign tumors showed no evidence of recurrence, while the patient with a malignant tumor received adjuvant radiotherapy. Endoscopic endonasal resection represents a safe, minimally invasive, and effective surgical option for selected OATs. The procedure demonstrates significant advantages in terms of clinical outcomes and complication avoidance. However, careful patient selection based on tumor characteristics and precise surgical planning remain crucial for optimal results. These findings support the clinical application of this technique for the management of orbital apex tumors.